Ho geez, wow, I guess it's time to blog again. Yikes. In my defense, I have been on an Internal Medicine Sub-internship (i.e. Sub-I) for the past month. That's a rotation where an M4 student acts like an independent intern, a sort of practice run before actual internship begins. Part of being a Sub-I is also having the schedule and workload of an intern, hence my absence. But enough excuses. How have I been? Thanks for asking.
The Air Force psychiatry rotation at San Antonio went well. I finally met other M4s on the HPSP scholarship who were applying to psych. It was exciting to meet future colleagues of mine. Even if we don't match in the same program, it's a small Air Force, so we'll probably bump into each other and work together eventually. Some highlights from Texas:
- Visiting the San Antonio Riverwalk. Pretty touristy, but it was still fun to listen to an acoustic soloist rendition of "Drunken Lullabies" and "Come Together" at Waxy O'Conner's. (I wonder if there's any relation to Ann Arbor's Conner O'Neill's...)
- Traveling to Houston for a weekend, visiting Martin Duncan and Sandy Williams.
- Making the 560-mile total round trip to an In-N-Out Burger in Fort Worth, Texas. I discovered this on a whim, messing around with my In-N-Out iPhone app while in Texas. Turns out there's actually quite a few branches in the Dallas area.
- Returning to Michigan in uniform and avoiding annoying baggage fees at the airport.
[Rental car during a 4-week psychiatry rotation: $820; Gas for a 560-mile total round trip: $56; Double-double with grilled onions, Animal-Style fries, and a medium Sweet Tea: $8.71; Medium-sized In-N-Out Burger Texas T-shirt: $10.28; Ending an away rotation in Texas with some California lovin': Priceless]
And of course, as mentioned above, I came back to my Medicine Sub-I at the VA. There was a poetic sense of homecoming, particularly because my very first clinical rotation of M3 year was Medicine at the VA. Not only that, but for this Sub-I I was assigned to the same team I was on during M3 year (Gold Team), and my senior resident for the first few days of the Sub-I was the intern I worked with during M3 year. Talk about taking a 360. At the same time, I was really amazed by how far I had come in a year. Although I am nowhere near senior resident level in terms of my knowledge base, it turns out that over the course of M3 year I had learned enough to be fairly independent in my work. Sure, I still needed to have my orders co-signed, but in the simplest terms, I felt "I knew what I was doing." Maybe not 100%, maybe for example there were diagnoses on a patient's differential that I wouldn't have considered unless my senior offered the possibilities, but for the most part I loved the feeling of getting into a groove. Having full control of my patients and running the show without working through an intern actually helped me remember daily plans and helped me keep track of orders better.
What's more, these past two rotations gave me the opportunity to teach and mentor M3s. In San Antonio I gave a teaching session on the differential diagnosis for psychosis, and at the VA I gave a similar but more medically-oriented presentation to the M3s on the work-up and management of altered mental status. I had alluded to these opportunities in my last blog post, and it was exciting to actually get to pass on pearls of knowledge. Although I may have come full circle during this last month, it's pretty obvious that my circle of experience has expanded considerably. What an awesome feeling.
[The components of a psychiatric history & physical. Whoops, just realized I forgot to include the Biopsychosocial formulation during this talk. Luke's teaching career, still a work in progress.]